Stomach Cancer

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What is stomach cancer?

Cancers in the stomach most commonly start in its lining. The tumors tend to grow slowly and may not produce symptoms early in the disease. Stomach cancers are also known as gastric cancers. Although common in other countries around the world, stomach cancers are relatively rare in the United States, where doctors diagnose around 26,000 new cases each year.

The risk of stomach cancer increases with Helicobacter pylori (H pylori) infection. This bacterium is a known cause of stomach ulcers. There are also other genetic and environmental risk factors for stomach cancer.

When stomach cancer symptoms develop, they can be due to bleeding in the stomach or because the tumor has grown large enough to interfere with appetite, swallowing or digestion. Pain or a sense of fullness can be common symptoms. Other symptoms may be less specific, such as weight loss, fatigue, and weakness.

The main stomach cancer treatment is surgery, often with chemotherapy and radiation therapy afterwards. Doctors may also use chemotherapy and radiation to treat stomach cancer that has spread.

Emergencies due to stomach cancer are rare. However, the tumor can start bleeding profusely or make a hole in the stomach wall. Seek immediate medical care (call 911) for symptoms such as:

  • Bloody stool

  • Confusion or loss of consciousness

  • Difficulty breathing

  • Pale or blue lips

  • Rapid heart rate

  • Severe nausea and vomiting

  • Sweating

  • Vomiting blood

Seek prompt medical care if you notice blood in your stool, which can be red, black, or tarry in texture, or if you have chronic stomach discomfort, problems swallowing, unexplained weight loss, or other symptoms that concern you.

What are the symptoms of stomach cancer?

Early stomach cancers often have no symptoms. As the tumor gets larger, it can interfere with digestion or swallowing. Because it is taking up space in the stomach, a sense of fullness may occur shortly after a person starts eating. Nonspecific symptoms such as unexplained weight loss, fatigue, and weakness can also occur.

Common symptoms and signs of stomach cancer include:

  • General sense of abdominal fullness

  • Change in bowel habits or bloody stool (the blood may be red, black, or tarry in texture)

  • Difficulty swallowing

  • Feeling full without eating much or loss of appetite

  • Indigestion or frequent belching or burping

  • Nausea with or without vomiting

  • Upper abdominal pain, which may get worse with eating

In some cases, complications of stomach cancer can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms:

  • Bloody stool, especially if the blood is bright red

  • Bluish coloration of the lips or fingernails

  • Change in consciousness, such as passing out or unresponsiveness

  • Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations or delusions

  • Rapid heart rate or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

  • Severe abdominal pain or severe nausea and vomiting

  • Vomiting blood

What causes stomach cancer?

Doctors do not fully understand the specific causes of stomach cancer. In general, cancer starts when normal cells begin growing out of control. The processes that keep cell growth in check fail in these cells. Genetic mutations are at the root of these changes, but it isn’t always clear why or how this happens. Scientists believe inherited and environmental factors can trigger mutations that eventually lead to cancer.

What are the risk factors for stomach cancer?

A number of factors increase the risk of developing stomach cancer. Not all people with risk factors will get stomach cancer. Research has linked Helicobacter pylori (H. pylori) infection with an increased risk of getting the disease. Other risk factors for stomach cancer include:

  • Age older than 50

  • Certain inherited conditions including familial adenomatous polyposis (FAP), hereditary diffuse gastric cancer (HDGC), hereditary nonpolyposis colorectal cancer (HNPCC), and BRCA1 or BRCA2 gene mutations

  • Certain medical conditions including gastritis, Barrett’s esophagus, achlorhydria (reduced stomach acid production), and pernicious anemia (decrease in red blood cells due to poor vitamin B12 absorption)

  • Diet high in smoked, salted or cured foods

  • Exposure to certain chemicals

  • Family history of stomach cancer

  • Male gender

  • Previous gastric resection

  • Smoking

Reducing your risk of stomach cancer

You may be able to lower your risk of stomach cancer by:

  • Eating fresh fruits and vegetables and limiting intake of smoked, salted or cured foods

  • Quitting smoking

  • Treating H. pylori infection if you have it

Treatments

How is stomach cancer treated?

The goal of treatment varies for the different stomach cancer stages. For early stomach cancers, the goal is to get rid of the cancer permanently. For more advanced stomach cancers, the goal of treatment may be to control spread of the disease, manage its symptoms or complications, and improve quality of life for patients and their families.

Common treatments for stomach cancer

Common treatments for stomach cancer include:

  • Chemotherapy to attack cancer cells

  • Participation in a clinical trial testing promising new treatments including combination treatments

  • Radiation therapy to attack cancer cells

  • Surgery to remove cancer

Immunotherapy and targeted therapy are also possible treatments, but they don’t work in all stomach cancer cases. Oncologists determine candidate patients for these therapies based on the pathology report of the tumor.

Other treatments for stomach cancer

Other therapies can help with your general health and complications of the cancer or its treatment including:

  • Antinausea medications if nausea occurs

  • Blood transfusions to temporarily replace depleted blood components (such as red blood cells or platelets)

  • Dietary counseling to help maintain strength and nutritional status

  • Pain medications as needed to increase comfort

  • Physical therapy to help strengthen the body, increase alertness, reduce fatigue, and improve functional ability during and after cancer treatment

  • Vitamin therapy to supplement those not easily absorbed by the remaining stomach

Complementary treatments

Complementary treatments may help some people to better deal with stomach cancer and its treatments. These alternative treatments may be useful in conjunction with traditional medical treatments. They are not substitutes for traditional medical care. Be sure to notify your doctor if you are using nutritional supplements or homeopathic remedies. They can interact with medical therapy.

Complementary treatments may include:

  • Acupuncture

  • Massage therapy

  • Nutritional dietary supplements, herbal remedies, tea beverages, and similar products

  • Yoga

Hospice care

Stomach cancer can progress to an advanced stage or stop responding to treatment. In this case, the goal of treatment may shift away from getting rid of the disease. Instead, treatment consists of measures to keep a person comfortable and maximize quality of life. Hospice care involves medically controlling pain and other symptoms, while providing psychological and spiritual support. It also provides support services for the patient’s family.

What are the potential complications of stomach cancer?

Complications of stomach cancer include:

  • Adverse effects of treatment

  • Anemia, which is a low red blood cell count

  • Ascites, which is swelling and buildup of fluid in the abdomen

  • Malnutrition

  • Perforation of the stomach, which is a hole in the stomach wall

  • Pyloric stenosis, which is an obstruction

  • Severe hemorrhage

  • Spread of cancer

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Jun 6
  1. Key Statistics for Stomach Cancer. American Cancer Society. https://www.cancer.org/cancer/stomach-cancer/about/key-statistics.html
  2. Gastric Cancer Treatment (PDQ®)–Health Professional Version. National Cancer Institute. https://www.cancer.gov/types/stomach/hp/stomach-treatment-pdq#section/_1
  3. Gastric Cancer Treatment (PDQ®)–Patient Version. National Cancer Institute. https://www.cancer.gov/types/stomach/patient/stomach-treatment-pdq#section/_1
  4. Ma JL, Zhang L, Brown LM, et al. Fifteen-year effects of Helicobacter pylori, garlic, and vitamin treatments on gastric cancer incidence and mortality. J Natl Cancer Inst 2012; 104:488.
  5. Signs and Symptoms of Stomach Cancer. American Cancer Society. https://www.cancer.org/cancer/stomach-cancer/detection-diagnosis-staging/signs-symptoms.html
  6. Stomach Cancer. American Society of Clinical Oncology. https://www.cancer.net/cancer-types/stomach-cancer/introduction
  7. Stomach Cancer Risk Factors. American Cancer Society. https://www.cancer.org/cancer/stomach-cancer/causes-risks-prevention/risk-factors.html
  8. Stomach Cancer Stages. American Cancer Society. https://www.cancer.org/cancer/stomach-cancer/detection-diagnosis-staging/staging.html
  9. Treatment Choices by Type and Stage of Stomach Cancer. American Cancer Society. https://www.cancer.org/cancer/stomach-cancer/treating/by-stage.html
  10. What Is Stomach Cancer? American Cancer Society. https://www.cancer.org/cancer/stomach-cancer/about/what-is-stomach-cancer.html
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